TSH receptor antibody–driven hyperthyroidism with autonomous nodules: Marine–Lenhart syndrome in practice

Graves’ disease with coexisting thyroid nodules has been described frequently, with the incidence increasing up to 35%. We describe a case of a middle-aged female with hyperthyroidism, high thyroid receptor antibody titer, and thyroid-associated orbitopathy with a thyroid nodule on ultrasonography. On the thyroid scan, the nodule was hyperfunctioning with increased background uptake in the rest of the thyroid gland. A diagnosis of Marine Lenhart syndrome was made, and the patient was managed with antithyroid drugs and planned thyroidectomy.